Blackmores The fodmap diet
20 Mar 2013
Blackmores

Blackmores

IBS support: FODMAP diet demystified

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Experts are learning more and more about the causes and treatment options for IBS, and Australian researchers have come up with an innovative diet to ease symptoms. Kathryn Terrill reports.

Probiotics
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FODMAPs, or ‘rapidly fermentable short-chain carbohydrates,’ are key suspects in causing symptoms associated with irritable bowel syndrome (IBS). In this new dietary approach, foods that are likely to cause bloating in the small intestine and bowel are removed. These include foods high in fructose, lactose, fructans, galactans and polyols (including sorbitol, mannitol, xylitol and maltitol).

Although this diet appears to reduce symptoms in up to 70 percent of people with IBS, it can be tricky to stick to according to Professor Nicholas Talley, Professor of Medicine at University of Newcastle, NSW. There have been different versions of the diet over time, but recent versions are also low in gluten. Seeing a specialised dietician is essential before trying to undertake a low-FODMAP diet.

Causes of IBS are complex and varied, but the most recent evidence suggests that a problem with the enteric nervous system (which is responsible for nerve signals to the gut) is one of the main factors involved. In IBS, it seems that nerves that regulate digestive function may be oversensitive and may cause changes in the movement of food matter through the digestive tract. This may help to explain the common symptoms of diarrhoea and constipation. It is important to realise, however, that psychological and dietary factors also play a role, which is where the FODMAP diet comes in.

FODMAP is an acronym for fermentable oligo-, di- and mono-saccharides and Polyols. These food components are excluded from FODMAP diet because they have the following characteristics: they are not absorbed well in the small intestine; they are small molecules that draw water into the gut; and they are easily fermented by intestinal bacteria.

Foods high in FODMAPs are considered more likely to cause IBS symptoms, yet it is important to remember that these foods do not cause IBS, but merely increase symptoms.


Examples of foods high in FODMAPs and some low-FODMAP alternatives are listed in the table below. Remember, this diet is best undertaken under the guidance of a specialist.

High FODMAP foods  Low-FODMAP alternatives 
Fruits
apples, pears, nashi pears, mango, sugar snap peas, watermelon, tinned fruit in natural juice, dried fruit, fruit juice, custard apple, rambutan, persimmon, apricots, cherries, lychee, nectarine, peaches, plums, prunes.

Vegetables
artichokes, asparagus, beetroot, Brussels sprout, broccoli, cabbage, fennel, garlic, leeks, okra, onions, peas, shallots, avocado, cauliflower, mushrooms, snow peas

Dairy products
Milk: cow, goat and sheep (regular & low-fat), Ice cream Yoghurt (regular & low-fat) Cheeses: soft & fresh (e.g. ricotta, cottage)

 		 Fruits
banana, blueberry, grapefruit, grape, honeydew melon, kiwifruit, lemon, lime, mandarin, orange, passionfruit, paw paw, raspberry, rockmelon, strawberry, tangelo.

Vegetables
bamboo shoots, bok choy, carrot, celery, capsicum, choko, choy sum, corn, eggplant, green beans, lettuce, chives, parsnip, pumpkin, silverbeet, spring onion (green only), tomato

Dairy products
Milk: lactose-free, rice milk Cheese:‘hard’ cheeses including brie, camembert Yoghurt: lactose-free Ice cream substitutes: gelati, sorbet Butter


References available on request

Low FODMAP recipes

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